Patterns of help-seeking for mental health problems in 1,001 neurodivergent adolescents who self-harm

Background. The prevalence of self-harm is higher in neurodivergent than in neurotypical individuals. Help-seeking is an important component of the management of mental health problems and self-harm, but neurodivergent individuals report encountering multiple barriers in accessing support.Aims. To understand whether and how neurodivergent adolescents who self-harm seek, receive, and perceive mental health support in comparison to their peers.Method. Participants were 12,209 adolescents (aged 11-18 years) from the OxWell 2023 Student Survey in English schools. Of these, 1,001 (8.2%) identified as neurodivergent and reported self-harm. We conducted three separate mixed-effect models to examine (1) help-seeking, (2) receipt, and (3) perceived helpfulness of the support. Results. Proportionally more adolescents who reported both self-harm and neurodivergence sought help compared to their peers who reported no self-harm and/or no neurodivergence. All adolescents were more likely to seek support from informal than formal sources and least likely to seek support online. Yet, neurodivergent adolescents who self-harm were more likely to seek formal support than their peers. When support was sought, adolescents in all groups were likely to receive it. However, those who reported either self-harm or neurodivergence were less likely to perceive the support received as helpful, especially from formal sources.Conclusion. Neurodivergent adolescents who self-harm report greater unmet need for mental health support, but not due to a lack of help-seeking. These findings, instead, point to issues with the appropriateness and acceptability of support received. This highlights the need for tailoring existing interventions to suit the specific needs of this population.